Following the conclusion of the clinical nutrition rotation, completion of a case study, based upon a patient seen during the rotation, was assigned. To meet the criteria of this assignment, I wrote about a patient who had congestive heart failure (CHF), hypertension (HTN), and coronary artery disease (CAD) using the information gathered during the assessment of the patient, which included a chart review and conversations with the patient. In addition, I researched specific conditions with which this patient presented. Completing this assignment reinforced the importance of using evidence based medicine in clinical nutrition practice as well as professional judgment in dealing with individual patients.
Using the American Dietetic Association’s Evidence Based Library, I researched nutrition issues associated with CHF, HTN, and CAD. Using this information, I evaluated the strength of the intervention I chose while caring for this patient against the intervention deemed appropriate in the literature. In doing so, I was able to determine that the intervention I chose while in the clinical setting was, as I expected, in fact in line with the evidence based medicine literature recommendations and guidelines that I found on the American Dietetic Association website. As a result, the value of such guidelines was strengthened as well as confidence in myself as a professional. This patient presented with a number of co-morbidities that needed to be addressed; upon completion of my rotation, I felt that I had provided the patient with the knowledge and tools necessary to make small, important changes for better health.
For this assignment, grading was based upon and points were assigned for preparation, introduction, content, style, and bibliography. I received 86 out of a total of 100 points with points being subtracted from the content, style, and bibliography sections of the case study. The feedback I received stated that with regards to content, I did not provide enough insight into the patient’s social history and its effect on current health status, nor did I provide an explanation of laboratory values obtained or possible drug-food interactions based upon the medications listed. As a result, I have learned to better explain the thought process behind a chosen intervention in order to provide the best evidence for the way in which I proceed with clinical treatment. I also received feedback regarding word choice throughout the paper, leading me to further proof my work before my final submission. Regarding the bibliography, minor errors were noted and since reviewing this case study, I have become familiar with the program Endnote, ensuring a proper bibliography for future assignments.
Prior to this assignment, I have always received excellent grades on written assignments and been told that I write well. This assignment was frustrating for me, however, because the information I was writing about was more technical than a typical essay. I found it difficult to make the paragraphs, especially those concerning the assessment of the patient, flow well without sounding choppy. While completing the case study, I thought I had done a good job of describing the assessment of the patient, even including a chart for food and nutrition history, laboratory data, anthropometrics, and client history. Having points taken off for content was, for me, more disappointing than having points taken off for the bibliography and since this assignment, I have worked to develop better technical writing skills.